Mancini Laura, Gibson Travis L, Grayson Barry H, Flores Roberto L, Staffenberg David, Shetye Pradip R
1 Hansjorg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, NY, USA.
Cleft Palate Craniofac J. 2019 Jan;56(1):31-38. doi: 10.1177/1055665618771427. Epub 2018 Apr 26.
To quantify 3-dimensional (3D) nasal changes in infants with unilateral cleft lip with or without cleft palate (UCL±P) treated by nasoalveolar molding (NAM) and cheilorhinoplasty and compare to noncleft controls.
Retrospective case series of infants treated with NAM and primary cheilorhinoplasty between September, 2012 and July, 2016. Infants were included if they had digital stereophotogrammetric records at initial presentation (T1), completion of NAM (T2), and following primary cheilorhinoplasty (T3). Images were oriented in 3dMD Vultus software, and 16 nasolabial points identified.
Twenty consecutively treated infants with UCL±P.
Nasoalveolar molding and primary cheilorhinoplasty.
Anthropometric measures of nasal symmetry and morphology were compared in the treatment group between time points using paired Student t tests. Postsurgical nasal morphology was compared to noncleft controls.
Nasal tip protrusion increased, and at T3 was 2.64 mm greater than noncleft controls. Nasal base width decreased on the cleft side by 4.01 mm after NAM and by 6.73 mm after cheilorhinoplasty. Columellar length of the noncleft to cleft side decreased from 2:1 to 1:1 following NAM. Significant improvements in subnasale, columella, and nasal tip deviations from midsagittal plane were observed. Treatment improved symmetry of the alar morphology angle and the nasal base-columella angle between cleft and noncleft sides.
Three-dimensional analysis of UCL±P patients demonstrated significant improvements in nasal projection, columella length, nasal symmetry, and nasal width. Compared to noncleft controls, nasal form was generally corrected, with overcorrection of nasal tip projection, columella angle, and outer nasal widths.
量化经鼻牙槽骨塑形（NAM）和唇鼻整形术治疗的单侧唇裂伴或不伴腭裂（UCL±P）婴儿的三维（3D）鼻变化，并与非唇裂对照进行比较。
2012年9月至2016年7月期间接受NAM和一期唇鼻整形术治疗的婴儿的回顾性病例系列。如果婴儿在初次就诊（T1）、NAM完成时（T2）以及一期唇鼻整形术后（T3）有数字立体摄影测量记录，则纳入研究。图像在3dMD Vultus软件中进行定向，并确定16个鼻唇点。
20例连续接受治疗的UCL±P婴儿。
鼻牙槽骨塑形和一期唇鼻整形术。
使用配对学生t检验比较治疗组不同时间点的鼻对称性和形态学人体测量指标。将术后鼻形态与非唇裂对照进行比较。
鼻尖突出度增加，在T3时比非唇裂对照大2.64mm。NAM后，腭裂侧鼻底宽度减少4.01mm，唇鼻整形术后减少6.73mm。NAM后，非腭裂侧与腭裂侧的鼻小柱长度从2:1降至1:1。观察到鼻下点、鼻小柱和鼻尖偏离正中矢状面有显著改善。治疗改善了腭裂侧与非腭裂侧鼻翼形态角和鼻底-鼻小柱角的对称性。
对UCL±P患者的三维分析显示，鼻突出度、鼻小柱长度、鼻对称性和鼻宽度有显著改善。与非唇裂对照相比,鼻形态总体得到矫正，鼻尖突出度、鼻小柱角和鼻外侧宽度过度矫正。
